A lot has been said lately about gun violence in America. I want to share a collection of sources that I have found most relevant to the debate and reflect my personal opinions about violence and society. I think about the national grieving that occurred, and continues for nearly the 3,000 Americans who died on September 11th. We have been involved in 3 wars, lost and wounded many more soldiers, and killed countless civilians in other countries as a result of the national outrage at such an attack on “American soil”. Yet, over 30,000 gun deaths occur annually in the U.S. …

I feel that to address the issue of gun violence we need to address the issue of violence in America. We can only address the problem by working to build communities that support young people, support the mentally ill, and support all of us who don’t fit into one of those categories but still need support. We all need support, and we all need to support others and challenge our ability to do more every day. That being said, I think that the conversations about gun control and mental health in this country can be constructive.

If we want to transform our collective outrage and sadness into hope and make progress on reducing violence in America, we should start with ideas that have produced results and build from there. Part of the plan needs to be about changing aspects of the way we support families to raise their children. This means starting at the beginning. One example of how to do this is the Nurse Family Partnership. However, long-term strategies for the prevention of violence, like the Nurse Family Partnership, are not enough. Young children learn violence from the older kids and adults around them who model violent behavior. If we want to change the future, we need to find ways to model different behaviors now. Organizations like Cure Violence, a national NGO operating in 15 cities, have shown how this can work.

I feel the pain in my city wherever I go
314 soldiers died in Iraq, 509 died in Chicago
-Kanye West, Murder to Excellence

Shortly after the Jovan Belcher tragedy I was asked on a television program whether or not the NFL player’s high-profile murder-suicide and sports announcer Bob Costas’ courageous comments about gun violence in the incident’s aftermath would have any impact on gun control in America. I answered that they would not. The reason? Because as I noted during that interview, historically our country has only addressed the issue of gun violence when it touches the lives of those with whom our leaders are most likely to identify. Rarely are those likely to be incidents involving people of color suffering domestic violence or teens of color from low-income communities who are victims of urban gun violence.

Instead the gun tragedies that have actually moved our elected officials to significant action on gun control have been those incidents in which victims are most likely to remind our leaders of their own friends, families and communities, incidents like the 1993 shooting on a Long Island Rail Road train, which killed commuters from New York’s professional class or the 1999 Columbine High School shooting, which made gun control the cause célèbre of white suburban moms, culminating in the Million Mom March in 2000.

Now it appears another incident is poised to finally move our leaders to action once again, 13 years after Columbine. The murder of 20 children and six adults in the quiet and normally safe enclave of Newtown, Conn., on Dec. 14 is forcing a conversation about gun control that the shooting of 26 residents in one night in Chicago this summer — resulting in the deaths of two teens and injury of 24 others — could not. As previously noted in an analysis by the now-defunct the Daily, more Chicago residents, many of them urban youth, were killed by gun violence in the first half of 2012 than American soldiers were killed in Afghanistan during the same period.

Just think about those numbers for a moment.

I think there is a good case to be made for gun control, because of the normal amount of killing that goes on with guns. I am a little more skeptical that gun control would reduce these [mass killings].” -David Brooks, PBS Newshour, December 14, 2012

MENTAL HEALTH

If we wanted to prevent the recent mass shootings through databases of people with mental health issues we would infringe on the rights of many more Americans than any gun legislation would. I hear pundits talk about the “mentally ill” as if it is easy to separate out the “dangerously mentally ill” and that such a label is consistent over time. Many states do not allow people who have been in a psychiatric facility to buy guns for a period of time, but the mass shootings in my memory would not have been prevented by any database of the mentally ill. In addition, the number of people who would benefit from mental health care is a huge proportion of society and treating those courageous enough to seek treatment and those forced into psychiatric care as dangerous, when the vast majority are not, only serves to further stigmatize these individuals and put up barriers to seeking treatment. By my estimate, any “database” that would be prevent mass shootings would likely encompass a quarter of Americans. How would the NRA feel about that? I think that would infringe on people’s rights a lot more than any gun control measure short of what they have in Japan (where gun violence is virtually non-existant).

New study links increased rate of infection to high patient ratios and burnout.

Nursing burnout leads to higher healthcare-associated infection rates (HAIs) and costs hospitals millions of additional dollars annually, according to a study published in the August issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

Researchers from the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing analyzed data previously collected by the Pennsylvania Health Care Cost Containment Council, the American Hospital Association Annual Survey, and a 2006 survey of more than 7,000 registered nurses from 161 hospitals in Pennsylvania.

The researchers used that data to study the effect of nurse staffing and burnout on catheter-associated urinary tract infections (CAUTI) and surgical site infections (SSI), two of the most common HAIs.

Job-related burnout was determined by analyzing the emotional exhaustion subscale from the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) that was obtained from nursing survey responses.

The MBI-HSS filters 22 items on job-related attitudes into emotional exhaustion, depersonalization, and personal accomplishment, identifying emotional exhaustion as the key component to burnout syndrome. More than one-third of survey respondents got an emotional exhaustion score of 27 or greater, the MBI-HSS definition for healthcare personnel burnout.

Comparing CAUTI rates with nurses’ patient loads (5.7 patients on average), the researchers found that for each additional patient assigned to a nurse, there was roughly one additional infection per 1,000 patients (or 1,351 additional infections per year, calculated across the survey population).

Additionally, each 10 percent increase in a hospital’s high-burnout nurses corresponded with nearly one additional CAUTI and two additional SSIs per 1,000 patients annually (average rate of CAUTIs across hospitals was nine per 1,000 patients; for SSIs it was five per 1,000 patients).

Using the per-patient average costs associated with CAUTIs ($749 to $832 each) and SSIs ($11,087 to $29,443 each), the researchers estimate that if nursing burnout rates could be reduced to 10 percent from an average of 30 percent, Pennsylvania hospitals could prevent an estimated 4,160 infections annually with an associated savings of $41 million.

“Healthcare facilities can improve nurse staffing and other elements of the care environment and alleviate job-related burnout in nurses at a much lower cost than those associated with healthcare-associated infections,” conclude the authors. “By reducing nurse burnout, we can improve the well-being of nurses while improving the quality of patient care.”

Too often, multiculturalism has come to be defined as “getting to know another culture.” And yet, in its present form, are we truly ‘multicultural’? If not, then what is still needed?

For many minorities, the term “multiculturalism” has come to mean:

a. That, once again, the dominant culture gets to decide what multicultural programs will look like, taste like and sound like. They will get to decide if something is too intense, too personal, too political, or too ethnic.

b. That, quite often, its definition is limited to the celebration of foods, dances, costumes and music.

c. That, by simply studying about Martin Luther King, Jr. or Cesar Chavez or Bruce Lee, we have learned all that we need to know about a certain ethnic group.

What does being truly multicultural really mean?

a. Multiculturalism means having a relationship based on a willingness to not only stay in the room when a conflict occurs, but to hear and value what is not working and to see that as an opportunity and not a threat.

b. Making use of our differences and unique perspectives. In other words, integrating different cultural practices into the way we manage others, create policy, develop and train leaders.

c. Taking responsibility for our part in the problem, instead of blaming someone else or attacking the messenger. In other words, making the workplace safe by valuing different perspectives and practices. Noticing who is missing in the room or needed for an honest and open discussion.

d. Truly wanting multiculturalism means to stop assessing and collecting more and more data, but to start instigating real changes, not five years from now, but today. As Martin Luther King, Jr. once said, “Wait means never.”

e. Asking minorities what they need by inviting them to be on the decision-making and planning committees, instead of making up countless programs that aren’t necessary or useful in addressing their problems.

I remember attending the Harm Reduction Coalition (HRC) conference for the first time in 2006, when it was held in Oakland, California. The experience was unlike that of any other conference I had ever attended. I remember being both shocked at how few young people of color were present and yet amazed at the diversity amongst conference goers. While I didn’t witness diversity in terms of race or among youth and adolescents, there was broad representation of active and non-active drug users, HIV prevention specialists, addiction specialists, friends and family of people impacted by drug use, and even members of faith-based communities.

At the time, I was newly employed by a youth organization that had always worked to incorporate harm reduction strategies into their work with young people (which seemed radical then). The Executive Director when I was there believed in exposing staff to harm reduction, as it seemed like a promising tool for addressing issues staff were facing at the drop-in center. To this end, the Director made it a priority to send 17 of her staff members as well as some participants all the way from Philadelphia to Oakland to experience an event that occurs once every two years. The workshops and the people were both fascinating. However, the general agreement amongst staff from my organization was that there were barriers keeping harm reduction and the harm reduction community from being accessible to young people and some per- sons of color. By the time we returned home, we learned that while there are diverse communities across the country (and beyond) practicing harm reduction, it would be necessary to develop different strategies in order to expose harm reduction principles to those who have traditionally been unable to access them.

Beyond that 2006 experience, I continued to attend harm reduction conferences. I also struggled with this idea that I needed to find opportunities to make harm reduction accessible to people who looked like me and had grown up with my experiences. Much like the young people I was working with, I grew up in a household with a Mother who struggled with her own addiction issues. I remember that the only option provided to my Mother was abstinence. For over 20 years, my mother suffered in silence – never feeling quite good enough for her family or the people in our community. I also lived the shame of her addiction; I felt unsupported in my personal decision to meet my mother where she was, while managing my own desires around the person I wanted her to be. We were confined to the limitations of a Narcotics Anonymous culture where cliché’s did not account for individual experiences; I struggled with what I perceived as the Christian-rooted, codependent nature of the program, which was operationalized in both covert and explicit ways.

The 8th National Harm Reduction Conference was held in Austin, Texas during the same year that I came to work for the Harm Reduction Coalition as a Capacity Building Advisor. I’m fortunate that in this role I get to work strategically and concertedly to promote harm reduction as a viable option, particularly for those within the helping profession. The bulk of my work and advocacy experience has been around HIV and I appreciate that capacity building has helped to sustain my interactions with HIV/ AIDS organizations. However, HIV- specific capacity building housed at a harm reduction organization has not only allowed me to expand my understanding of harm reduction from a drug use perspective, but also from an organizational perspective. This has meant offering organizations ways to identify potential harms incurred by an agency’s participants or staff – in addition to public perception of the agency – as a result of its mission and policies.

The “harm reduction for agencies” concept comes from some of the work I have done with organizations that serve Black men who have sex with men (BMSM). It was through my capacity building work that I started to hear employees question certain dynamics, institutions and policies within their organizations, and more broadly, within the field. For example, I heard people exploring things like the impact of all white leadership in institutions that serve BMSM as well as issues that come up when BMSM participants are hired to do outreach in the communities where they live, date and/or frequent. Another taboo topic raised in these conversations — which came out as a common issue at some agencies — is intimate relationships between staff members or between staff and participants. These issues are all potentially harm-initiating factors that could threaten the sustain- ability of organizations and prevent core values from being fully experienced in a positive, empowering way. I recognize that some groups struggle with harm reduction – such as people of color and young people; however perhaps it is because the institution of harm reduction has been inaccessible to them. By inaccessible I mean that despite the fact that people use forms of harm reduction within their everyday lives, the concept of harm reduction has been stigmatized and misrepresented as tool for promoting drug use and the legalization of drugs. The people of color in my community – teachers, young people, politicians, and parents – are often times already stigmatized as drug users because of what they look like or where they live and have, therefore, worked hard to be disassociated with any perceived promotion of drug use. In addition, I think that harm reduction has meant different things to different people; in turn, messaging consistency has become complicated and resulted in rejection from populations who could benefit from it.

Exploring new strategies

I spent the last six years thinking about what my contribution to harm reduction could be, and it was at the 2011 conference where I was able to actualize that opportunity. I worked with a colleague at HRC to develop and present a workshop entitled, “Different People Common Ground: The intersections of Human Relations and HIV Prevention”. The workshop deconstructed value assumptions and invited conference attendees to examine service provision through the lens of oppression. This workshop challenged participants to process change through the ecological model, examining the implications of the social environment while also being empowered by the impact an individual can make on society. The ecological model is rooted in domestic violence prevention. It draws on systems theory to dissect social systems to more clearly identify what promotes and sustains problems on the individual, interpersonal/relationship, community and societal levels. For example – let’s assume an agency has recently hired a participant to provide outreach services. Let’s also assume that the employee was subsequently reprimanded a few times for engaging in “inappropriate” behavior with other participants during outreach hours. The ecological model may be a useful tool for this organization to gain a broad yet specific perspective of the issue (see figure).

From the individual perspective – thinking about what is going on internally – the employee might indicate that knowing everyone in the neighborhood makes it difficult for her to engage professionally. The employee might feel that it is not a “big deal” because these people are her friends and her relationship with these people is actually the reason that other participants are more likely to engage in service.

From the relationship perspective, it’s possible that the employee is feeling pressure to engage in familiar behaviors, and to be the “same person” amongst her friends that she was before she was hired by the agency. This tension can complicate things.

The community area of influence asks us to question the culture or climate within an organization that might promote or perpetuate certain behaviors or interpersonal dynamics. Continuing the example above, the community perspective may look for contradictions or inconsistencies in policy that could have had an impact on the situation. Perhaps the agency tolerates informal relationships to a degree – such as a program manager and program staff person who are best friends or even a staff member and a participant who are roommates. The newly hired outreach worker may be confused by these different boundaries, recognizing that, to some degree, there is a relationship beyond a professional one. Agency tolerance of the other relationships (for whatever reasons) may lead the outreach worker to feel that she can also navigate the professional and familiar roles with agency participants. Lastly we have the societal level, which speaks to the structural forces that create policies and procedures, and that further impact the way an agency exist. For example, policies around employee and participant fraternization are intended to protect the agency from liability. However, most of these policies do not take into account the likelihood that community members who are hired because of their association with a target population may carry a greater burden as a result of such policies than staff that are not. This could result in heightened frustration among outreach workers primarily because a great deal of their support might come from the community and participants of the organization.

The information within this framework reveals where harm exists beyond a traditional perspective that simply seeks to govern participants. Rather, the analysis also encourages management to revisit ideas around who and how to hire, as well as how to create a working environment that does not ask participants to compromise themselves or their relationships for minimum wage. The ecological model also helps participants in understanding the complexity of potential harms from various perspectives. This means that organizations can be more intentional about the work they do and the people they do it with and for.

The workshop in Austin attracted a broad range of participants from Centers for Disease Control Program Officers to outreach workers and other frontline staff to volunteers, all seeking to make a greater impact within their agency. The workshop focused on leadership development, managing up, internal capacity building and succession planning. Some of the hopes coming out of the workshop were that people will be able to see harm reduction in a different context – a context that promotes harm reduction values and usability beyond its most common association which is injection drug use. It’s important that the general messages around harm reduction and its principles promote values such as empowerment and individualism, while establishing options with people to reduce harm. Lastly, it is equally important that we develop collective values about packaging harm reduction as a philosophy and ensure that these values reflect the complex needs of all people. After all, what good is useful strategy if it is inaccessible to the people who stand to gain the most from it?

Michael T. Everett is the Team Leader for the Harm Reduction Coalition’s Capacity Building Assistance Program. For the past 12 years, Michael has been working in non-profits with various populations most impacted by HIV/ AIDS and other social health issues. Michael holds a Masters degree in Human Services and is currently working on a Doctoral degree in Education.

Five years ago, Colton and Mandersheidi surveyed mortality data from eight states and concluded that, on average, Americans with major mental illness die 14 to 32 years earlier than the general population. The average life expectancy for people with major mental illness ranged from 49 to 60 years of age in the states they examined — a life span on par with many sub-Saharan African countries, including Sudan (58.6 years) and Ethiopia (52.9 years).ii Average life expectancy in the United States is 77.9 years.iii It would appear that the increase in longevity enjoyed by the general U. S. population over the past half century has been lost on those with serious mental illness (SMI). In fact, this drop in life expectancy due to mental illness would surpass the health disparities reported for most racial or ethnic groups. Yet this population is rarely identified as an underserved or at-risk group in surveys of the social determinants of health. iv

Why is there such a profound disparity in life expectancy for those with SMI? Disorders such as schizophrenia, major depression, and bipolar disorder are risk factors for suicide, but most people with SMI do not die by suicide. Rather, the 5 percent of Americans who have SMI die of the same things that the rest of the population experiences — cancer, heart disease, stroke, pulmonary disease, and diabetes. They are more likely to suffer chronic diseases associated with addiction (especially nicotine), obesity (sometimes associated with antipsychotic medication), and poverty (with its attendant poor nutrition and health care) and they may suffer the adverse health consequences earlier.

The risks are striking. People with a mental illness are more than twice as likely to smoke cigarettes and more than 50 percent more likely to be obese compared to the rest of the population.v But this only partly explains the premature mortality. Recently, when Druss and colleagues analyzed the early mortality data derived from a nationally representative survey, they found three drivers: clinical risk factors, socioeconomic factors, and health system factors. vi

The clinical risk factors include the frequent co-occurrence of mental illness with heart disease, diabetes or other medical conditions, generally referred to as “comorbidity.” For example, people with major depressive disorder are at higher risk for cardiovascular disease and stroke.vii Conversely, for those who have had a heart attack, experiencing depression increases their risk for cardiac-related death three-fold, more than any cardiovascular variable except congestive heart failure. And people with diabetes have double the risk for depression.viii We do not fully understand the relationship between diabetes or heart disease and depression, but current thinking attributes the increased risk to both depressive behaviors (e.g., poor diet, low activity, low adherence to treatment) as well as some common biology such as elevated inflammatory factors.

While we are still trying to understand the cause of comorbidity between mental disorders and other health problems, the health system factors may offer a better short-term target for change. Few people in the public mental health care system are receiving high quality health care.ix

The Patient Protection and Affordable Care Act outlines a specific model of integrated care, the patient-centered medical home (PCMH), which could improve access and quality of health care to those with multiple chronic disorders. The PCMH model includes comprehensiveness, holistic patient-centered care, and, emphasis on care in the community. The Centers for Medicare and Medicaid Services has been tasked with piloting a series of PCMHs and studying their impact over the coming years with the goal of wider dissemination in the future. Knowing that people with SMI are a high risk group for multiple chronic disorders and targeting the PCMH for their specific needs could be an effective approach to improving health outcomes for the entire population.

Short of a new health care system, there are models for improving health outcomes for people with mental illness. Collaborative care, in which primary care and mental health providers work closely together to deliver effective treatments within the primary care setting, represents a fundamental change toward addressing mental disorders in conjunction with other physical conditions. Over the past two decades more than 40 research trials have demonstrated the effectiveness of the collaborative care model. In the case of major depression, for example, studies have shown collaborative care programs to be an effective approach for treating depression alongside other conditions, and to be more cost-effective than standard treatment. A recent study indicates that implementing this approach for depression in the Medicare system would result in cost savings of approximately $15 billion annually. x

Collaborative care for depression and diabetes or depression and heart disease is the proverbial low hanging fruit. What about schizophrenia and bipolar disorder, which are usually treated in specialty mental health clinics rather than primary care? Is it better to add primary care capacity to the behavioral health center or to integrate patients with SMI into primary care? Can our current system, which separates behavioral health from health care, ever be “equal” in quality or outcomes? These remain research questions of urgent importance.

The unavoidable fact is that we will not improve overall longevity or contain health care costs in this nation without addressing the needs of the nearly 5 percent of Americans with serious mental illness. This is a population that not only dies early; they have multiple chronic diseases requiring expensive care, often in emergency rooms and intensive care units. We need better strategies for dealing with this urgent public health issue and we need to ensure that whether these strategies are collaborative care for depression or an innovative medical home for those with serious mental illness, we implement these interventions where the need is greatest.

Originally Published September 06, 2011 by the National Institute of Mental Health:

A recent article published in America’s Wire discussed the scope of race-related health disparities and the financial implications for the U.S. health care system.

The article focuses on how racial and ethnic health care disparities can affect earning capacity within a household, which can have long-lasting adverse effects on the entire family, particularly children. In addition, where one lives is a significant contributor to the existence of racial-related health disparities, Thomas A. LaVeist, director of the Hopkins Center for Health Disparities at the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, noted. “Where you live determines what schools your children get to attend… It also determines whether you are exposed to environmenta

l inequalities and the type of health care facility that is available to you,” LaVeist said. According to the study cited in the article, 30.6 percent of medical expenditures from 2003 to 2006 for blacks, Asians and Hispanics were costs due to health inequalities. For the same years, the findings also indicated $229.4 billion in direct medical costs and $1 trillion in indirect costs associated with illness and premature death could be reduced with the elimination of health disparities. The National Center on Minority Health and Health Disparities noted that people of color are far more likely to lack health insurance. People of color make up roughly one-third of the U.S. population but more than half of the people who are uninsured, according to the article.

Sinsi Hernandez-Cancio, director of health equity at Families USA, noted that chronic disease is a major problem and that millions of dollars are spent battling preventable diseases, such as diabetes, stroke, and heart disease. “We pay now or pay later. We’re going to be paying the price in higher health care costs, but also a population that is less healthy and unable to participate in the nation’s economic recovery,” said Smedley (Alleyne, 03/01).

America’s Wire, a key proponent of the Maynard Media Center on Structural Racism (MMCSR), is funded under a grant awarded by the W. K. Kellogg Foundation. Our goal is to provide to our subscribers comprehensive stories on the impact of structural racism in America. We hope this content will better inform Americans about communities of color and the many challenges that they continue to face from structural racism.

Eliminating the racial disparities inherent to our nation’s criminal-justice policies and practices must be at the heart of a renewed, refocused, and reenergized movement for racial justice in America.

This month the United States celebrates the Selma-to-Montgomery marches of 1965 to commemorate our shared history of the civil rights movement and our nation’s continued progress towards racial equality. Yet decades later a broken criminal-justice system has proven that we still have a long way to go in achieving racial equality.

Today people of color continue to be disproportionately incarcerated, policed, and sentenced to death at significantly higher rates than their white counterparts. Further, racial disparities in the criminal-justice system threaten communities of color—disenfranchising thousands by limiting voting rights and denying equal access to employment, housing, public benefits, and education to millions more. In light of these disparities, it is imperative that criminal-justice reform evolves as the civil rights issue of the 21st century.

Below we outline the top 10 facts pertaining to the criminal-justice system’s impact on communities of color.

While people of color make up about 30 percent of the United States’ population, they account for 60 percent of those imprisoned.The prison population grew by 700 percent from 1970 to 2005, a rate that is outpacing crime and population rates. The incarceration rates disproportionately impact men of color: 1 in every 15 African American men and 1 in every 36 Hispanic men are incarcerated in comparison to 1 in every 106 white men.

According to the Bureau of Justice Statistics, one in three black mencan expect to go to prison in their lifetime.Individuals of color have a disproportionate number of encounters with law enforcement, indicating that racial profiling continues to be a problem. A report by the Department of Justice found that blacks and Hispanics were approximately three times more likely to be searchedduring a traffic stop than white motorists. African Americans were twice as likely to be arrested and almost four times as likely to experience the use of force during encounters with the police.

Students of color face harsher punishments in school than their white peers, leading to a higher number of youth of color incarcerated. Black and Hispanic students represent more than 70 percent of those involved in school-related arrests or referrals to law enforcement. Currently, African Americans make uptwo-fifths and Hispanics one-fifth of confined youth today.

According to recent data by the Department of Education, African American students are arrested far more often than their white classmates. The data showed that 96,000 students were arrested and 242,000 referred to law enforcement by schools during the 2009-10 school year. Of those students, black and Hispanic students made up more than 70 percent of arrested or referred students. Harsh school punishments, from suspensions to arrests, have led to high numbers of youth of color coming into contact with the juvenile-justice system and at an earlier age.

African American youth have higher rates of juvenile incarceration and are more likely to be sentenced to adult prison. According to the Sentencing Project, even though African American juvenile youth are about 16 percent of the youth population, 37 percent of their cases are moved to criminal court and 58 percent of African American youth are sent to adult prisons.

As the number of women incarcerated has increased by 800 percentover the last three decades, women of color have been disproportionately represented. While the number of women incarcerated is relatively low, the racial and ethnic disparities are startling. African American women are three times more likely than white women to be incarcerated, while Hispanic women are 69 percent more likely than white women to be incarcerated.

The war on drugs has been waged primarily in communities of color where people of color are more likely to receive higher offenses. According to the Human Rights Watch, people of color are no more likely to use or sell illegal drugs than whites, but they have higher rate of arrests. African Americans comprise 14 percent of regular drug users but are 37 percent of those arrested for drug offenses. From 1980 to 2007 about one in three of the 25.4 million adults arrested for drugs was African American.

Once convicted, black offenders receive longer sentences compared to white offenders.The U.S. Sentencing Commission stated that in the federal system black offenders receive sentences that are 10 percent longer than white offenders for the same crimes. The Sentencing Project reports that African Americans are 21 percent more likely to receive mandatory-minimum sentences than white defendants and are 20 percent more like to be sentenced to prison.

Voter laws that prohibit people with felony convictions to vote disproportionately impact men of color.An estimated 5.3 million Americans are denied the right to vote based on a past felony conviction. Felony disenfranchisement is exaggerated by racial disparities in the criminal-justice system, ultimately denying 13 percent of African American men the right to vote. Felony-disenfranchisement policies have led to 11 states denying the right to vote to more than 10 percent of their African American population.

Studies have shown that people of color face disparities in wage trajectory following release from prison.Evidence shows that spending time in prison affects wage trajectories with a disproportionate impact on black men and women. The results show no evidence of racial divergence in wages prior to incarceration; however, following release from prison, wages grow at a 21 percent slower rate for black former inmates compared to white ex-convicts. A number of states have bans on people with certain convictions working in domestic health-service industries such as nursing, child care, and home health care—areas in which many poor women and women of color are disproportionately concentrated.

Theses racial disparities have deprived people of color of their most basic civil rights, making criminal-justice reform the civil rights issue of our time. Through mass imprisonment and the overrepresentation of individuals of color within the criminal justice and prison system, people of color have experienced an adverse impact on themselves and on their communities from barriers to reintegrating into society to engaging in the democratic process. Eliminating the racial disparities inherent to our nation’s criminal-justice policies and practices must be at the heart of a renewed, refocused, and reenergized movement for racial justice in America.

There have been a number of initiatives on the state and federal level to address the racial disparities in youth incarceration. Last summer Secretary of Education Arne Duncan announced the Schools Discipline Initiative to bring increased awareness of effective policies and practices to ultimately dismantle the school-to-prison pipeline. States like California and Massachusetts are considering legislation to address the disproportionate suspensions among students of color. And in Clayton County, Georgia, collaborative local reforms have resulted in a 47 percent reduction in juvenile-court referrals and a 51 percent decrease in juvenile felony rates. These initiatives could serve as models of success for lessening the disparities in incarceration rates.